Gender Difference in Blood Pressure Control among Low-Income Individuals (B40) with Hypertension in Malaysia: the RESPOND Study

Abstract

Hypertension is a major modifiable determinant of the increasing burden of cardiovascular disease (CVD) in Malaysia. The aim of this study is to determine the factors associated with hypertension control in men and women among the low-income individuals (B40) group with hypertension in Malaysia. The communities were selected from rural and urban populations in four peninsular states. Following a multistage sampling approach, communities in each stratum were selected according to probability proportional to the size and identified based on national census data by the community and administrative registers. Eligible individuals were those aged between 35 and 70 years old, self-reported or identified as hypertensive at screening. A survey using validated questionnaires was conducted. The prevalence of controlled hypertension was 33.1% (95%CI: 24.7, 41.5) in men and 34.0% (95%CI: 29.0, 39.0%) in women respondents. In men, hypertension control rates were positively associated with individuals who received or heard any information about hypertension [(Adj. OR: 2.95 (95%CI: 1.02, 8.52)], having two or more comorbidities [Adj. OR: 6.38 (955CI: 1.37, 29.62)] and those who had regular treatment for hypertension [Adj. OR: 14.51 (95%CI: 1.46, 44.21)]. Whereas, in women, hypertension control rates were positively associated with race whereas the non-Malay had more controlled status compared to Malay [Adj. OR: 5.94, (95%CI: 1.26, 28.09)] and those who regularly see the health professional [Adj. OR: 5.68 (95%CI: 1.94, 16.63)]. Health education and promotion programs need to be conducted to disseminate more information about hypertension to the community. Clinical services need to be improved mostly on regular follow up, giving proper consultation on treatment and treating patients to increase the prevalence of hypertension control.